Acute Coronary Syndrome;

Abstract

Introduction: Atherosclerosis is intrinsically an inflammatory disease. Numerousstudies has shown that elevated levels of C-reactive protein (CRP) are associated with increasedcardiovascular risk. The objectives of this study was to determine the correlation of clinicaloutcome in terms of 30 day mortality with various level of C-reactive proteins among patientspresenting with acute coronary syndrome Study Design: Descriptive. Setting: Department ofCardiology, Punjab Institute of Cardiology Lahore. Period: 06 months. Material and Methods:Total 250 patients presented in emergency department and diagnosed as cases of acutecoronary syndrome base on history of chest pain, ECG and cardiac biochemical markers wereincluded in the study. Management of ACS was continued while CRP levels of each patientwere measured by latest Agglutination method. Results: Our study included 250 patients withacute coronary syndrome with a mean age of 52.90±10.34 years. Male patients were 220(88%). Regarding the clinical presentation of patients, 20 (8%) had unstable angina, 95(38%)had NSTEMI and 135 (54%) had STEMI.CRP level were measured, 184(73.6%) patients hadCRP levels < 22mg/L with mortality of 12 (6.5%) at 30 days and 66 (26.4%) patients hadCRP levels >22mg/L with mortality of which 13(19.6%) at 30 days. The mean CRP level was17.9±12.47, 18.08±15.73 and 22.38 + 17.92 for patients with unstable angina, NSTEMI andSTEMI respectively. The stratification of data for effect modifiers showed that 60(24%) patientshad diabetes, 138 (55.2%) patients had hypertension and 65(26%) patients were smokers.Conclusion: Patients having higher CRP levels had higher risk of 30 day mortality.